Two-Stage Treatment of Facial Asymmetry Caused by Unilateral Condylar Hyperplasia

Abstract

Condylar hyperplasia (CH) is a rare, self-limiting process manifesting between the first and third decades of life. CH causes facial asymmetry and derangement of the occlusion. Management involves resection of the condylar head and orthognathic surgery. This paper describes the case of a 37-year-old woman with spontaneous onset of CH over a span of approximately 25 years. The condition was managed with resection of the condyle alone, which dramatically improved facial asymmetry and altered the occlusion within a few months of follow up. Orthodontic treatment was then carried out and the patient underwent orthognathic surgery after 3 years. The patient is currently satisfied with her appearance and function and there are no signs of recurrence. T w o -S t a g e T r e a t m e n t o f F a c i a l A s y m m e t r y C a u s e d b y Unilateral Condylar Hyperplasia

Prosthodontic management of a patient with mandibular asymmetry: a case report

“…Understanding the etiology of mandibular asymmetry is important in the management of patients [1]. Common Causes of Mandibular Jaw Deviation are summarized in Table 1 [8,9].…”

“…In this case, the investigation into the cause for mandibular asymmetry was inconclusive and no underlying cause was determined. It is likely that the deviation was the result of developmental abnormalities ( Table 2) [8,9].…”

“…Potential causes of mandibular asymmetries [8,9]. Affects the mandible unilaterally • Presents as transverse displacement of the chin point to contralateral side which presents in earlyadulthood • No vertical asymmetry • The contralateral mandibular molars deviate lingually in attempt to remain in occlusion • Cross-bite may develop on the unaffected side • Radiographic elongation of the condyle or body of mandible on the affected side Hemimandibular hyperplasia • Horizontal and vertical enlargement on one side of the mandible which involves the condyle, ramus, and body of the mandible• The condition usually begins in puberty • The maxillary dentition on the affected side will overerupt to compensate for the excessive vertical mandibular growth, which results in a characteristic transverse cant of the maxillary occlusal plane Atropy of hard and soft tissues on one side of the face leading to mandibular asymmetry • May be accompanied by hyperpigmentation of the skin, seizures, and facial pain…”

Progressive facial asymmetry resulting from condylar osteochondroma – A case report detailing the resection, subsequent orthognathic intervention and custom joint replacement

“…Treatment can therefore be categorised into either a one-stage or two-stage procedure. 8 Generally orthognathic input can be avoided if the occlusion post operatively is acceptable. Equally, orthodontic camouflage can be utilised e.g.…”

Manejo Quirúrgico de la Hiperplasia Condilar Tipo 2: Reporte de un Caso

“…Robert Adams en 1836 fue el primero en reportar la HC, la etiología aún no está bien establecida, sin embargo, se atribuye a factores genéticos, alteraciones en la vascularidad local, traumatismos, procesos infecciosos, alteraciones endocrinas entre otros (Bharathi et al, 2014). Las características clínicas son; asimetría facial, alteraciones en la articulación temporomandibular, maloclusiones y desviación mandibular (Mehrotra et al, 2011), la asimetría asociada a dicha condición se ha clasificado en tres categorías: hiperplasia mandibular, elongación mandibular y la combinación de las dos anteriores (Xavier et al, 2014).…”